From On Healing to a “View between Villages” across America
This article will be updated as new destinations, stories, and experiences are added.
In January 2025, I began traveling across the country for the book tour for my book, On Healing. The book grew from a question I had been asking for years as a physician, journalist, researcher, and patient: What actually helps us heal?
The answers were never confined to a clinic. Healing was shaped by sleep and food, movement and meaning, relationships and grief, the places where people lived, and whether they felt seen. On the book tour, from New York and Connecticut to California, Arizona, Florida, Massachusetts, Illinois, and Colorado, I heard people describe health in similarly expansive terms. They wanted good medical care, of course. But they also wanted time, trust, community, clear information, and some sense of agency.
The tour ended back in April 2025, and seeded the idea for Evra as an AI-enabled science-backed whole person health platform designed to connect the dots between a person's medical records, laboratory results, medications, wearable data, daily habits, and social circumstances and turn them into practical next steps, with human care when it is needed. As Evra took shape, our team began hearing directly from users across the world, including from all over the U.S. I had more time to learn from users in Maine and Texas as well. This led to the 100 Years Project, and a series of interviews in the Fall and Winter of 2025 at the National Mall in Washington DC with people from all over the US, as well as a few international residents. After spending most of the first part of Summer 2026 in San Francisco, engaging with partners and investors, it became clear that Silicon Valley is a bubble for wellness and longevity, and immensely disconnected from how most people navigate health day-to-day.
So I went back on the road – my first idea had been to rent a VW minibus and drive it from Northern California across the Mountain West, Midwest, and South with some people on my team (or perhaps my partner would volunteer – he hesitated, understandably). The next best thing was to simply fly to some of the places I hadn’t travelled to in 2025, especially the places that are currently debating healthcare and many other issues ahead of the midterms.
The Evra Health ‘Listening Tour’ picked up where the On Healing tour left off. I traveled through the intermountain West, Midwest, and South, speaking with people in cities and small towns, at farmers' markets, hotels, salons, festivals, parks, cafés, and in the back seats of rideshares. I asked what made it hard to stay healthy, what people wished the healthcare system understood, and what kind of support would genuinely help.
The route covered thousands of miles: from Reno, Mammoth Lakes, Bozeman, Jackson Hole, Salt Lake City, southern Utah, to Des Moines, Omaha, Ann Arbor, Denver, Indianapolis, Louisville, and Nashville. New Hampshire and Vermont would come next. Conferences will take me to New Orleans, Louisiana, next week, Madison, Wisconsin in October, and Orlando Florida in November, and I’ll surely learn more.
Throughout the journey, I kept returning to Noah Kahan’s song “The View Between Villages” (extended version). From the road, the country began to feel less like a collection of separate places and more like a network of interconnected villages. Each had its own landscape, politics, history, and pressures. But beneath those differences were strikingly similar hopes.
The landscapes changed dramatically. The core message did not: people are being asked to take responsibility for their health inside systems that make that responsibility extraordinarily difficult.
Health is local
In the West, the sheer geography of health became impossible to ignore. Moving through Nevada, Montana, Wyoming, Utah, and Texas, I kept thinking about distance: not only the distance to a clinician or hospital, but the distance between generic health guidance and the realities of a particular place.
A recommendation that sounds simple -- to see a specialist, find a therapist, buy healthier food, exercise regularly -- can become complicated by a long drive, extreme weather, shift work, caregiving, limited local services, or cost. In mountain and rural communities, access can be shaped as much by roads and seasons as by insurance networks. Across California and Nevada, I also saw the contrast between regions saturated with wellness culture and communities still struggling to secure the basics of continuous primary care.
This became one of the tour's central lessons: healthcare may be delivered nationally, but health is lived locally. Any technology intended to help must understand place: what resources exist nearby, what they cost, whether a person can reach them, and whether the proposed next step is realistic in the context of that person's life.
Idaho: beauty, growth, and uneven access
Idaho revealed some of the sharpest contrasts of the tour. Boise’s rapid growth has brought opportunity, but also a rising cost of living that affects housing, food, transportation, and people’s ability to prioritize their health. Farther north, Sun Valley and Ketchum are strikingly beautiful and attract extraordinary wealth—including the annual Allen & Company conference—yet that prosperity exists alongside a seasonal workforce facing a very different reality.
I spoke with a tour guide who had moved to Idaho from another state. She enjoyed the energy and business that visitors bring to Sun Valley and Ketchum during the busy season, but said the rest of the year could be difficult, often requiring people to work multiple jobs. Her experience showed how seasonal income, housing costs, and unstable employment become social determinants of health: even in a wealthy destination, the people who keep it running may struggle to secure consistent care and meet everyday needs.
Outside these enclaves, rural Idaho faces shortages across primary care, mental health, and dental care, compounded by long travel distances and limited local services. The state’s new rural-health investment may help expand its workforce, telehealth, and care infrastructure, but the lesson from Idaho was already clear: the presence of wealth in a community does not guarantee access for the people who live and work there.
Nevada: growth beyond the wellness bubble
In Nevada, Reno’s growth and access to nature contrasted with the realities facing people outside larger population centers, where distance, extreme weather, and limited services can complicate even basic care. It reinforced that health guidance must account for geography, affordability, and whether a person can realistically reach the support being recommended.
Wyoming: wealth does not guarantee access
In Wyoming, Jackson Hole’s beauty, tourism, and concentrated wealth existed alongside high housing costs, a seasonal workforce, and the challenges of delivering healthcare across a large, sparsely populated state. The contrast showed how people can live and work near extraordinary resources without necessarily having consistent access to affordable care themselves.
Southern Utah: distance as a determinant of health
Across southern Utah, the scale of the landscape made distance feel like a social determinant of health in its own right. Long drives, extreme heat, limited transportation, and fewer nearby clinicians can turn a routine appointment or specialist referral into a significant logistical burden—making locally relevant and digitally supported care especially important.
Montana: community across great distances
In Montana, Bozeman’s rapid growth and increasing cost of living contrasted with the realities of smaller and more remote communities, where people may travel long distances for primary, specialty, or behavioral healthcare. The experience reinforced that rural health depends not only on clinicians and technology, but also on transportation, affordability, local relationships, and strong community networks.
Iowa: prevention in a place carrying a heavy burden
At the Iowa State Fair and around Des Moines, conversations about health quickly became conversations about affordability, agriculture, environmental exposure, and the future of the state. Iowa's high cancer burden was on people's minds, as were concerns about nitrate runoff and the economic and political tensions surrounding it.
I met Corey, an 83-year-old who expressed something I would hear in different forms throughout the tour: people need a primary-care clinician who can act as a quarterback. Not another disconnected service. Not another portal. Someone - or a coordinated system - that can see the whole field, help interpret what matters, and guide the next play.
A young engaged couple spoke about trying to build a stable future on a teacher's salary. Their concerns illustrated how closely health is tied to economic security. Prevention is often framed as a matter of personal discipline, yet it is difficult to prioritize future risk when housing, groceries, insurance, and everyday bills already compete for attention.
Nebraska: coordination is not a luxury
In Omaha, I spoke with Judy and Laura, both in their late sixties. They described the shortcomings of AI-assisted clinical dictation when it failed to capture their words accurately, a small example of a much larger issue. Technology can save time, but only if people can trust that it hears them correctly.
Our conversation returned to the idea of universal primary care. They compared it to managing a kitchen renovation: without someone coordinating the work, even capable specialists can produce a fragmented and frustrating result. That metaphor stayed with me. American healthcare often gives patients a collection of parts and calls it a system.
Nebraska also surfaced the particular constraints of rural care: workforce shortages, long travel distances, and communities responding to crises such as fentanyl and methamphetamine with whatever infrastructure they have—including the social glue built through churches, volunteer firehouses, and community gatherings. These informal networks are not peripheral to health. In many places, they are part of the care infrastructure.
Michigan: coverage does not always mean access
In Ann Arbor, I heard two different versions of the same frustration. A 49-year-old living with migraines and epilepsy described the complexity of managing chronic illness over time. A graduate student from Canada described having insurance in the United States but still facing a high deductible, while also remembering long waits in the Canadian system.
Together, their stories resisted easy ideological answers. Coverage matters enormously, but an insurance card alone does not guarantee timely, affordable, coordinated care. At the same time, nominally universal access can still leave people waiting. The real goal must be access to high-quality primary care that is both financially and practically available.
Michigan also deepened my thinking about social determinants of health. I met with a researcher studying housing and health, and we discussed how screening for needs is only the first step. Asking whether someone is worried about housing, transportation, or food does little unless the answer leads to a relevant resource. A useful system must be able to connect a person's stated need to support in their ZIP code, with a broader state-level option when local help is unavailable. We made this possible last week through the Evra platform.
Ohio: memory, aging, and the power of community
On a 4 hour flight I met Deb, whose family's Ohio farm has endured for more than 150 years. She spoke about concerns related to Alzheimer's disease and the importance of community support.
Her story reminded me that prevention is not only about extending life. It is about protecting identity, memory, independence, and connection for as long as possible. People want to understand their risks, but they do not want to be reduced to risk scores. They want useful steps and the reassurance that they will not face aging or illness alone.
Indiana: skepticism born from experience
In Indianapolis, conversations at the Garfield Park Farmers Market, around Fountain Square, and near the Cressy hip-hop festival brought me into contact with younger adults worried about healthcare costs. There was also skepticism about sweeping promises of universal care.
That skepticism did not strike me as apathy. It felt earned. Many people have seen ambitious language coexist with unaffordable bills, confusing coverage, and little improvement in their day-to-day access. Trust will not be restored through slogans. It will be restored when people can get an appointment, understand the cost, retrieve their records, and receive help before a manageable problem becomes a crisis.
Kentucky: when records fail to follow the patient
Louisville made fragmentation tangible. A rideshare driver who had served as a military medic described difficulty transferring records through the veterans' healthcare system. A person's medical history should not become less visible because they crossed from one institution to another -- especially after military service -- but this remains a routine source of delay and frustration.
Another resident, managing anxiety and ADHD while working two jobs, illustrated a different kind of fragmentation. The healthcare system often assumes people have spare time: time to call during business hours, compare providers, attend appointments, fill prescriptions, prepare meals, and follow up. Many do not. A plan that ignores time scarcity is not a viable care plan.
Kentucky's struggles with opioids, fentanyl, and methamphetamine also underscored the limits of episodic intervention. By the time distress becomes visible in an emergency department, opportunities for earlier support may have been missed. Prevention must include mental and behavioral health, and it must be able to recognize deterioration between visits -- not simply document it afterward.
Tennessee: the daily logistics of staying well
In Nashville, I spoke with a woman in her twenties who grew up across California, Mexico, and Tennessee and now works in a nail salon. She lives with interstitial cystitis; many of her friends are managing autoimmune conditions such as lupus and Hashimoto's disease. She likes her family doctor, but no one at her salon has employer-sponsored insurance. She was automatically enrolled in a Marketplace option, yet affordability remains the central concern.
She uses wearables, tries to reach her step goals, and wants to go to the gym. But long salon shifts make meal planning and ordering healthy food difficult. Her experience captured the gap between knowing what supports health and having the structure to do it. She did not need another lecture about discipline. She needed clear, manageable steps, affordable care, and social support, especially after her mother moved back to Mexico and could not easily return to visit.
Elsewhere in Tennessee, conversations turned to the price of medications, including statins and GLP-1 drugs; marketplace coverage; rural hospital closures; maternal mortality; and the state's burden of obesity and diabetes. These issues are often discussed as separate policy categories. In people's lives, they converge.
New Hampshire: Access, aging, and belonging
In Hanover, I spoke with someone in their thirties who described how waitlists made it difficult to access healthcare: even something as routine as an eye examination. It reinforced that insurance coverage is not the same as timely care. I also met a group of friends -- including retired doctors, businesspeople, and a social worker -- who gather every Friday morning at a local café called The Works to catchup for a few hours, and then head on to hike part of the Appalachian Trail and have been discussing where and how they want to age. Some use wearables and others do not, but their most powerful health resource is their community and sense of belonging. New Hampshire’s shortages in primary care, behavioral health, nursing, and home-based care -- along with reductions in Medicare Advantage options -- make aging in place more difficult, particularly in rural areas. Remaining at home requires more than personal motivation: it depends on clinicians, caregivers, transportation, affordable coverage, and people who continue to show up for one another. This is even more of an issue with those who work for themselves, as artists, musicians, or in the trades.
Vermont: Community and empowerment without shame
In Vermont, conversations repeatedly returned to community, shared values, and gathering outdoors. At the University of Vermont, I encountered a culture that connects the health of people with the health of the planet, alongside students thinking seriously about public and global health and AI’s role in healthcare. At a Burlington Unitarian Universalist service centered on justice, equality, and equity, I learned about the “Love Feast” -- a tradition of gathering around food and fellowship -- and spoke with a longtime Vermonter who works as an art therapist about the state’s changing progressive identity. She offered to host Evra team members for a rally or gathering about primary care -- something we may take her up on.
Louisiana
In New Orleans, I spoke with Gilberto, whose path from exercise science at Tulane to culinary school was reshaped by Hurricane Katrina. He became a head chef known for blending Creole cuisine with other traditions, including crawfish enchiladas.
Gilberto described the grueling realities of restaurant work: long hours on his feet, little time off, and meals delayed until midnight. It reminded me of hospital medicine, which I explore in Chapter Six of On Healing: the people caring for others often have the least time to care for themselves.
His experience also reflects Louisiana’s broader health challenges. The state faces a heavy burden of diabetes, cardiovascular disease, and obesity, alongside major maternal and infant health disparities. Access remains uneven, particularly in rural communities, despite Louisiana’s decision to expand Medicaid. Environmental exposures along the industrial corridor between New Orleans and Baton Rouge, as well as hurricanes, flooding, and extreme heat, add another layer—disrupting care, worsening mental health, and making chronic disease management more difficult.
Louisiana is beginning to address some of these gaps. A new state law will require insurance coverage for postpartum home visits beginning in 2027—an important response to the state’s maternal and infant mortality crisis. Yet policy solutions must also account for people like Gilberto, whose health is shaped by demanding work, irregular meals, language access, and the lasting effects of disasters such as Katrina.
Gilberto has already lost 10 pounds while trying to improve his health without a GLP-1 medication. He walks, tracks his macronutrients, and researches chronic disease prevention. As a Spanish speaker, his experience also highlights the need for trustworthy health information across languages and cultures.
His story shows what personalized healthcare should provide: not simply more information, but practical guidance shaped around a person’s work, environment, culture, goals, and daily life.
What people are asking for
Across these conversations, few people asked for more health information. Most were already surrounded by it. They asked, explicitly or implicitly, for help making sense of it.
Not one person shared that they trust the latest wellness or biohacking podcast. No one asked about trends like cold plunges or peptides.
They wanted to know which lab result mattered, what to do next, what they could afford, and when a concern was serious enough to escalate. They wanted their records to follow them. They wanted technology that listened accurately and reduced work instead of creating another inbox. They wanted care that recognized food, housing, transportation, work schedules, family support, and geography as part of health and well-being not as an afterthought or simply something to ignore.
Above all, they wanted a trusted quarterback for their health and their health goals.
That does not have to mean recreating an idealized version of the family doctor working alone. It could mean a modern primary-care team supported by responsible AI: a system that monitors changes between visits, organizes scattered information, makes the next step clear, connects people to local resources, and brings in a human clinician when judgment, empathy, or escalation is required.
The goal is not an AI chatbot standing between people and care. It’s infrastructure that helps people reach the right care sooner, and helps clinicians see what would otherwise remain hidden.
Listening before building
The On Healing tour taught me that healing is both deeply personal and profoundly social. This listening tour has shown me the corollary: healthcare cannot become more humane unless it is designed around the conditions in which people are actually trying to heal.
As I traveled through Kentucky and Tennessee, Wendell Berry, the Kentucky writer, farmer, and thinker whose work helped shape my understanding of healing, passed away at 92. In On Healing, I quote his essay “The Body and the Earth,” in which he describes healing as a return to wholeness. That idea inspired the book’s subtitle, A Return to Wholeness. I owe a great deal to Berry: not only to what he shared through his writing, but to the way he chose to live: rooted in place, community, responsibility, and the natural world.
His example feels especially important in a culture, and at times a self-help industry, that can be driven by visibility, celebrity, and ego. Berry offered something quieter, more authentic, and more grounded. Speaking with people across the country reminded me that this is what most people are looking for, too: not grand promises or performative solutions, but practical, trustworthy support grounded in the realities of their lives.
That means listening before building. It means resisting the temptation to treat every problem as a failure of individual behavior. And it means measuring innovation not by how advanced it sounds, but by whether it makes care more continuous, affordable, intelligible, and human.
Inspired by a conversation during my Michigan stop, Evra’s social determinants of health screener is now officially live in the app. It identifies needs related to housing, food, transportation, income, utilities, caregiving, safety, education, and healthcare access, then uses a person’s zip code to connect them with relevant local resources and state or national support.
The map of this journey traces a route across America. But the more important map is the one emerging from the stories: a teacher trying to plan a future, an older adult asking for a quarterback, a veteran searching for his records, a salon worker managing chronic illness without employer-sponsored insurance, and families trying to preserve memory, independence, and hope.
Each town was its own village, yet none was truly separate from the others. The tour itself became a kind of mobile village, built conversation by conversation – I’m grateful for my training as a medical journalist and articles I’ve reported on for ABC News, the New York Times, Wired, and many more for cementing the power of story and meaning.
That is also why language matters. The people I met were not simply “users,” market segments, or data points. They were people, like you, me, our neighbors, our friends, our colleagues, our leaders.
Speaking with them -- in rural communities and cities, across different incomes, ages, and political environments -- made the commonalities much more visible than the differences we’re so often shown.
Again and again, people wanted the same fundamental things: to live full and meaningful lives, to preserve their independence, to avoid preventable illness and hospitalization, and, when possible, not to spend the end of life in a hospital.
Health, in other words, was not the destination. It was what allowed people to participate in their families and communities, pursue meaning, and live more fully. Their experiences point toward a simple mandate: we do not need more disconnected pieces or solutions imposed from a distance. We need a system that connects the dots, a system that makes (at the very least) primary care accessible and affordable for all. And we need this to work in the context of responsible AI, and a thoughtful approach that places people and planet first.
At Evra we are more committed to this mission than ever.
- Amitha
